Anthem class action settlement overview:
- Who: Anthem Insurance Cos. Inc. and related entities agreed to a proposed class action settlement with health plan participants.
- Why: Plaintiffs claim Anthem unlawfully denied coverage for proton beam radiation therapy used to treat cancer.
- Where: The proposed class action settlement was filed in Tennessee federal court.
Anthem agreed to pay approximately $3.6 million to resolve a proposed class action lawsuit alleging the company improperly denied insurance coverage for proton beam radiation therapy used in cancer treatment.
The settlement was filed in an Employee Retirement Income Security Act (ERISA) lawsuit brought by plaintiff Todd J. Taylor and other health plan participants who challenged Anthem’s coverage denials for the treatment.
Taylor filed the lawsuit in 2023 against Anthem and Blue Cross Blue Shield Healthcare Plan of Georgia Inc., alleging the companies violated ERISA through unlawful denials of proton beam therapy claims. Proton beam therapy is a targeted form of radiation treatment used for certain cancers.
According to the case, Taylor participated in a self-funded employer-sponsored health plan administered by Anthem and sought coverage for proton beam therapy to treat prostate cancer.
The parties reportedly reached a settlement following a full-day mediation session earlier this year. Anthem now operates under the name Elevance.
Proposed settlement to compensate eligible class members who submit claims
Under the proposed class action settlement, Anthem agreed to create a $3,625,000 settlement fund that will be distributed to eligible class members after deductions for attorneys’ fees, litigation costs, service awards and settlement administration expenses.
Class members who submit valid claim forms would be eligible to receive compensation from the settlement fund.
The proposed settlement class includes ERISA health plan participants who allegedly had proton beam therapy claims denied by Anthem or its affiliates.
Anthem does not admit any wrongdoing or liability through the agreement and expressly denies the allegations raised in the class action lawsuit.
The plaintiffs asked the court to preliminarily approve the settlement and authorize notice to class members.
Last year, Anthem agreed to pay $12.875 million to resolve claims it improperly denied coverage for mental health and substance use disorder treatment based on overly restrictive medical necessity guidelines.
What do you think about this Anthem class action settlement? Let us know in the comments.
The plaintiffs are represented by Jordan Lewis of Jordan Lewis P.A., Alyson S. Beridon of Herzfeld Suetholz Gastel Leniski & Wall PLLC, Robert R. Sparks of Strauss Troy and John A. Yanchunis of Morgan & Morgan Complex Litigation Group.
The Anthem class action lawsuit is Taylor, et al. v. Anthem Insurance Companies Inc., et al., Case No. 3:23-cv-00541, in the U.S. District Court for the Middle District of Tennessee.
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